Transcription of Prior Authorization (General) 1.
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Prior Authorization (General) 1.
1 December 27, 2021 Prior Authorization Process for Certain Hospital Outpatient Department (OPD) services Frequently Asked Questions (FAQs) Prior Authorization (General) 1. Q: What is Prior Authorization ? A: Prior Authorization is a process through which a request for provisional affirmation of coverage is submitted for review before the service is rendered to a beneficiary and before a claim is submitted for payment. The Prior Authorization program for certain hospital OPD services ensures that Medicare beneficiaries continue to receive medically necessary care while protecting the Medicare Trust Funds from unnecessary increases in the volume of covered services and improper payments.
A: Prior Authorization for the initial five services (blepharoplasty, botulinum toxin injections, panniculectomy, rhinoplasty, and vein ablation) started on June 17, 2020 for dates of service on or after July 1, 2020.
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